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Sifelani Tsiko
Agric, Environment & Innovations Editor
President Mnangagwa recently opened the country’s first school of optometry at Bindura University of Science Education. In this interview, Sifelani Tsiko (ST), Agric, Environment & Innovations Editor speaks to BUSE Vice Chancellor Prof Eddie Mwenje (EM) about how the new school will train optometrists and transform access to eye care services for thousands of people affected by poor vision in the country.

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ST: What motivated the Bindura University of Science Education (BUSE) to establish an optometry school?

EM: The dire need for eye care services and a dearth of human resources in sub-Saharan Africa motivated the setting up of new optometry programmes. Optometry, has, over the past 10 years, emerged as a profession strategically positioned to address the burden of poor eye care service in developing countries, Zimbabwe included. Globally, 285 million people are estimated to be visually impaired, of whom 39 million are blind and 246 million living with low vision.

Although about 80 percent of the causes of visual impairment are preventable, researchers have projected a rise in the prevalence of visual disorders, particularly for sub Saharan Africa due to poor access to eye care services. With just 11 percent of the global population, sub Saharan Africa is plagued with about 24 percent of the global burden of visual impairment and blindness.

The nations within this region have the least number of eye care professionals and do not meet the minimum human resources requirement of one eye health professional for every 55 000 people. This imbalance together with limited eye care facilities contribute immensely to the high prevalence of visual impairments observed in the region.

In Zimbabwe alone, eye health experts estimate that 10 percent of the population is blind with the major causes of blindness being cataracts, glaucoma, trauma, diabetes complications and refractive errors. While the burden of eye health is high in Zimbabwe, there has been no training of optometrists 40 years after independence.

As at 1993, there were five countries in Africa with optometric teaching institutes. These were Sudan, Ghana, Nigeria, South Africa and Tanzania. The latest to join the trail is Zimbabwe.

Bindura University of Science Education has launched a four-year degree programme leading to the award of BSc Optometry, the first of its kind in Zimbabwe. The programme was thus launched to address the skills deficit in this important area as indicated by our national imperatives.

ST: How much was invested in the establishment of the school?

EM: BUSE, has had to invest over US$20 million into the optometry programme because it was non-existence in any university in Zimbabwe. The investment ranges from infrastructure, initial stakeholders’ meeting, curriculum development, recruitment of expatriate human resource, laboratories and clinic, equipment and logistics and other operational and administrative costs.

All these amount to a significant monetary investment. We are indeed very grateful to the Government for injecting more than US$4,5 million for the optometry clinic.

ST: Could you briefly tell us about the scope of practice and training at the school of optometry. How many students have you enrolled at the school so far? What is your future target?

EM: Optometry is a healthcare profession that is autonomous and regulated and optometrists are the primary healthcare practitioners of the eye and visual system who provide comprehensive eye and vision care, which includes diverse management of eye care services. Optometry practice in Zimbabwe is regulated by the Pharmacists Council of Zimbabwe.

The scope of practice is closely tied to the level of training. The world governing body of Optometrist, the World council of Optometry (WCO), advocates that to practice the full scope of optometry, training institutions should gradually adopt the Doctor of Optometry programme, (OD).

Being a regulated profession, an optometrist’s scope of practice may differ depending on the location. Thus, disorders or diseases detected outside the treatment scope of optometry are referred to relevant medical professionals for proper care, more commonly to ophthalmologists who are physicians that specialise in tertiary medical and surgical care of the eye.

Since inception, there are 36 students in three groups, Part 1, 2 and 3 each comprising 12 students at our university. The immediate future target is to double the number to 24 students per intake.

We are also working on expanding the school of health sciences to include other related programmes such as ophthalmology.

ST: Do you have an adequate and well trained team of lecturers at the school?

EM: In Zimbabwe, there are very few people with an MSc degree in Optometry, which is the minimum requirement by Zimbabwe Council of Higher Education for one to teach undergraduate students. Our university entered into a Memorandum of Understanding with University of Cape Coast in Ghana for staff and students exchange.

Most of its lecturers are from University of Cape Coast besides one qualified Zimbabwean who is the head of the department. The university has also received science professors from Cuba through a government technical agreement.

We are expecting some professors from Cuba to join us soon. Furthermore, we have an MoU with Dania Academy in Denmark for staff and student exchange.

We have received significant support from a retired optometrist from Dania Academy — Mr Finn who has sourced equipment being used by the department both for teaching and in the clinic.

ST: In what way is the School of Optometry going to advance and transform the country’s eye care services in terms of affordability, accessibility and equity?

EM: The World Health Organisation is envisaging the incorporation of primary eye care and has proposed universal health coverage of one optometrist for every 250000. With 15 local and 20 expatriate optometrists the coverage is far less than expected in Zimbabwe.

It has naturally been practical to have these optometrists servicing major towns and cities leaving those in the rural areas without access to the service.

The service has thus tended to be expensive for most people since the cost of living in towns tends to be more and for those from the rural areas they have to budget for transport costs to go to the cities. The other problem is that there is no post for a government optometrist in Government hospitals and as such our hospitals lack such facilities.

This is only offered by the Council for the Blind — a local organisation which also doesn’t have suitably qualified optometrist. The training of optometrists at our university will ensure the country has suitably qualified eye care professionals. It is envisaged that accessibility will increase as practices become decentralised.

The school will offer both teaching services as well as serve the public from Bindura and beyond. The school will endeavour to improve access to eye care services and offer free eye care services to vulnerable members in communities through our partnerships with international organisations.

We will strive to bring awareness to uncorrected visual impairments to communities and create awareness about the significance of optometry as a profession.

ST: What are some of the major challenges you are facing as you consolidate the establishment of the school?

EM: As indicated above the major challenge is lack of suitably qualified lecturers locally, the remuneration of expatriate staff which requires foreign currency and the capital intensity in running an optometry programme. The equipment for the laboratories and clinic all have to be imported.

ST: How do you hope to address some of these challenges?

EM: It is expected that after 2022 when the first group qualifies some of the graduates will be encouraged to go into academia by acquiring MSc and doctorate qualifications to augment the teaching staff. Secondly it is expected that improvement of our economy will lead to a significant improvement in the remuneration offered helping us to attract expatriates.

Government support will continue to be needed for procurement of equipment for training and the payment of expatriate staff. The university will continue to build more partnerships with other reputable universities in Africa and beyond for staff and student exchange.

President Mnangagwa pledged support to ensure that the school develops and achieves its strategic mandate to serve the country.

ST: In what way do you think public – private sector partnerships can help support the growth and training of the school?

 EM: It is important to mention that our university has a Memorandum of Understanding with Optinova Pvt limited which helped the university a lot in developing the programme. Special mention and appreciation goes to Dr Solomon Guramatunhu who played a crucial role in the conception of the programme.

The partnership will continue to be important for the university. We are also grateful to the private sector which has offered scholarships to our students studying at our university.

The private sector is expected to also help in industrial attachment or work related learning of the students. The private sector will be expected to extend their support to provide scholarships for postgraduate training and research which is a critical element of the profession.

Optometry has some sub-specialities like contact lenses, orthoptics and ocular pathology management which normally come as certificate or diploma qualifications and expectations are that these will be offered by the school. There have also been donations of frames and lenses from a local laboratory ORMAC — C N Mtuwa mostly for teaching purposes.

ST: What are your future hopes for the School of Optometry? How do you see it helping the country to attain its Vision 2030 of a middle income status?

EM: The future of the school is mainly to be a centre of excellence in optometry and vision sciences playing a lead role in solving the many visual challenges facing Zimbabwe and Africa at large. The school will be self-sustainable contributing to the vision of the World Health Organisation (WHO) of a world in which nobody is needlessly visually impaired and where there is universal access to comprehensive eye care services.

In so doing, the school will help Zimbabwe to attain its Vision 2030 of a middle income status. Visual impairment due to uncorrected refractive error causes a lot of unnecessary economic and social consequences to Zimbabwe and other developing countries.

Visual impairment due to uncorrected refractive error is easily correctable by means of spectacles or contact lenses which are currently very expensive in Zimbabwe for the majority of the people. Optometrists are now considered significant health personnel in the eye care delivery system largely due to their role in treating uncorrected refractive error, the leading cause of visual impairment globally.

Central to this challenge is the need to develop a professional workforce that is adequately trained to manage the burden of uncorrected visual error which is the mandate of the optometry programme at the BUSE.